摘要
目的探讨控制性减压术对颅脑外伤患者再灌注损伤的影响。方法选取2014-03至2017-03医院收治的颅脑外伤100例,依据治疗方法分为控压组和标压组,每组50例,标压组给予标准减压术治疗,控压组给予控制性减压术治疗,比较两组白介素-6(IL-6)、缺血修饰蛋白(IMA)、E神经元特异性烯醇化酶(NSE)、治疗疗效、并发症、死亡等情况。结果控压组和标压组术后血清IL-6、IMA、NSE水平明显低于术前,控压组术后血清IL-6、IMA、NSE水平明显低于标压组,差异有统计学意义(P<0.05);控压组治疗有效率(96.0%)明显高于标压组(78.0%),差异有统计学意义(P<0.05);控压组并发症发生率(8.0%)明显低于标压组(30.0%),差异有统计学意义(P<0.05),但两组患者病死率无统计学差异(4.0%vs 8.0%,P>0.05)。结论控制性减压术可有效改善颅脑外伤患者脑氧摄取能力,减少再灌注损伤和并发症,值得推广。
Objective To explore the effect of controlled decompression on reperfusion injury in patients with craniocerebral trauma. Methods One hundred patients with craniocerebral traum treated in our hospital between March 2014 and March 2017 were selected as subjects. According to the therapeutic method,these patients were divided into the pressure control group（ 50 cases） and the standard pressure group（ 50 cases）. The pressure control group was treated with controlled decompression,while the standard pressure group was treated with standard decompression. The levels of interleukin-6（ IL-6）,ischemia modified protein（ IMA）,neuron specific enolase（ NSE）,treatment efficacy,complications and death rate were compared between the two groups. Results After operation,levels of serum IL-6,IMA,and NSE of the two groups were significantly lower,especially in the pressure control group,and the difference was statistically significant（ P〈0. 05）. The effective rate of treatment of the pressure control group（ 96. 0%） was significantly higher than that of the standard pressure group（ 78. 0%）,and the difference was statistically significant（ P〈0. 05）. The rate of complications of the pressure control group（ 8. 0%） was significantly lower than that of the standard pressure group（ 30. 0%）,and the difference was statistically significant（ P〈0. 05）. But the mortality of the two groups was basically the same. Conclusions Controlled decompression can effectively improve cerebral oxygen uptake in patients with craniocerebral trauma,reduce reperfusion injury and complications,so it＇s worthy of clinical promotion.
作者
雷志恒
LEI Zhiheng(Department of Neurosurgery, the First College of Clinical Medical Science, China Three Gorges University, Yichang 443000, China;Department of Neurosurgery, Yichang Central People＇s Hospital, Yichang 443000, China)
出处
《武警医学》
CAS
2018年第5期483-486,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
控制性减压术
颅脑外伤
再灌注损伤
controlled decompression
craniocerebral trauma
reperfusion injury
